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Comparison of Mortality and Readmission in Non-Ischemic Versus Ischemic Cardiomyopathy After Implantable Cardioverter-Defibrillator Implantation.

Publication ,  Journal Article
Higgins, AY; Bjerre, J; Parzynski, CS; Minges, KE; Ahmad, T; Desai, NR; Enriquez, A; Spatz, ES; Friedman, DJ; Curtis, JP; Hlatky, MA; Freeman, JV
Published in: Am J Cardiol
October 15, 2020

Data is lacking on the contemporary risk of death and readmission following implantable cardioverter-defibrillator (ICD) implantation in patients with non-ischemic cardiomyopathies (NICM) compared with ischemic cardiomyopathies (ICM) in a large nationally representative cohort. We performed a retrospective cohort study using the National Cardiovascular Data Registry ICD Registry linked with Medicare claims from April 1, 2010 to December 31, 2013. We established a cohort of NICM and ICM patients with a left ventricular ejection fraction ≤35% who received a de novo, primary prevention ICD. We compared mortality and readmission using Kaplan-Meier curves and Cox proportional hazard regressions models. We also evaluated temporal trends in mortality. In 31,044 NICM and 68,458 ICM patients with a median follow up of 2.4 years, 1-year mortality was significantly higher in ICM patients (12.3%) compared with NICM (7.9%, p < 0.001). The higher mortality in ICM patients remained significant after adjustment for covariates (hazard ratio [HR] 1.40; 95% confidence interval [CI] 1.36 to 1.45), and was consistent in subgroup analyses. These findings were consistent across the duration of the study. ICM patients were also significantly more likely to be readmitted for all causes (adjusted HR 1.15, CI 1.12 to 1.18) and for heart failure (adjusted HR 1.25, CI 1.21 to 1.31). In conclusion, the risks of mortality and hospital readmission after primary prevention ICD implantation were significantly higher in patients with ICM compared with NICM which was consistent across all patient subgroups tested and over the duration of the study.

Duke Scholars

Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

October 15, 2020

Volume

133

Start / End Page

116 / 125

Location

United States

Related Subject Headings

  • United States
  • Survival Rate
  • Retrospective Studies
  • Registries
  • Patient Readmission
  • Myocardial Ischemia
  • Middle Aged
  • Male
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Higgins, A. Y., Bjerre, J., Parzynski, C. S., Minges, K. E., Ahmad, T., Desai, N. R., … Freeman, J. V. (2020). Comparison of Mortality and Readmission in Non-Ischemic Versus Ischemic Cardiomyopathy After Implantable Cardioverter-Defibrillator Implantation. Am J Cardiol, 133, 116–125. https://doi.org/10.1016/j.amjcard.2020.07.035
Higgins, Angela Y., Jenny Bjerre, Craig S. Parzynski, Karl E. Minges, Tariq Ahmad, Nihar R. Desai, Alan Enriquez, et al. “Comparison of Mortality and Readmission in Non-Ischemic Versus Ischemic Cardiomyopathy After Implantable Cardioverter-Defibrillator Implantation.Am J Cardiol 133 (October 15, 2020): 116–25. https://doi.org/10.1016/j.amjcard.2020.07.035.
Higgins AY, Bjerre J, Parzynski CS, Minges KE, Ahmad T, Desai NR, et al. Comparison of Mortality and Readmission in Non-Ischemic Versus Ischemic Cardiomyopathy After Implantable Cardioverter-Defibrillator Implantation. Am J Cardiol. 2020 Oct 15;133:116–25.
Higgins, Angela Y., et al. “Comparison of Mortality and Readmission in Non-Ischemic Versus Ischemic Cardiomyopathy After Implantable Cardioverter-Defibrillator Implantation.Am J Cardiol, vol. 133, Oct. 2020, pp. 116–25. Pubmed, doi:10.1016/j.amjcard.2020.07.035.
Higgins AY, Bjerre J, Parzynski CS, Minges KE, Ahmad T, Desai NR, Enriquez A, Spatz ES, Friedman DJ, Curtis JP, Hlatky MA, Freeman JV. Comparison of Mortality and Readmission in Non-Ischemic Versus Ischemic Cardiomyopathy After Implantable Cardioverter-Defibrillator Implantation. Am J Cardiol. 2020 Oct 15;133:116–125.
Journal cover image

Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

October 15, 2020

Volume

133

Start / End Page

116 / 125

Location

United States

Related Subject Headings

  • United States
  • Survival Rate
  • Retrospective Studies
  • Registries
  • Patient Readmission
  • Myocardial Ischemia
  • Middle Aged
  • Male
  • Humans
  • Female